Provider Demographics
NPI:1205665304
Name:LEWIS, MADISON (MA, LPCC)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7329 S PLATTE RIVER PKWY UNIT 207
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4301
Mailing Address - Country:US
Mailing Address - Phone:408-421-7726
Mailing Address - Fax:
Practice Address - Street 1:12835 E ARAPAHOE RD STE P
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3940
Practice Address - Country:US
Practice Address - Phone:720-689-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0021568101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health